Service de Dermatologie, Hôpital Cochin, Université Paris 5, France, Pavillon Tarnier, 89 rue d'Assas, 75006 Paris, France.
Eur J Dermatol. 2010 May-Jun;20(3):349-53. doi: 10.1684/ejd.2010.0925. Epub 2010 Mar 19.
Local anaesthesia with lidocaine is widely used in dermatology. The aim of this study was to evaluate pain at different times of dermatological surgery when using local anaesthetic agents. 120 consecutive patients were included during a 3 month period in a dermatological day surgery unit. Pain was estimated by a visual analogue scale, before, during and at the end of the operation. At the end, patients were asked about their satisfaction with local anaesthesia or their preference for general anaesthesia. Fifty five patients had lesions on the face and neck. Other localisations were chest (20 cases), limbs (24 cases), perineum (18 cases) and not recorded in 3 cases. Mean diameter of the lesions was 25.3 mm. Pain occurred during anaesthetic injection in 88.5% of the patients and the score was 5 or more in 42 patients. No pain was recorded during and at the end of the operation in 112 and 118 patients respectively. Fifteen patients would have preferred general to local anaesthesia because of intense pain. Local anaesthesia was judged appropriate by 86% of the patients. However, for lesions of the perineum, general anaesthesia would have been preferred by 38.8% of the patients.
利多卡因局部麻醉在皮肤科广泛应用。本研究旨在评估皮肤科手术不同时间使用局部麻醉剂时的疼痛程度。在皮肤科日间手术单元的 3 个月期间，连续纳入 120 例患者。在手术前、手术中及手术结束时，通过视觉模拟评分法评估疼痛。最后，询问患者对局部麻醉的满意度或对全身麻醉的偏好。55 例患者病变位于面部和颈部。其他部位包括胸部（20 例）、四肢（24 例）、会阴部（18 例），3 例未记录。病变的平均直径为 25.3 毫米。88.5%的患者在麻醉注射时出现疼痛，42 例患者的评分为 5 或更高。分别有 112 例和 118 例患者在手术中和手术结束时无疼痛记录。15 名患者因疼痛剧烈而更愿意接受全身麻醉而不是局部麻醉。86%的患者认为局部麻醉是合适的。然而，对于会阴部的病变，38.8%的患者更愿意接受全身麻醉。
